Research Lab Results for cardiac
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Adamo Cardiac Immunology Lab
Lab WebsiteOver the last few decades, a growing body of evidence has shown that the immune system is intim...ately connected with cardiac development, function and adaptation to injury. However, there is still much to learn and currently there are no immunomodulatory treatments to prevent or treat heart dysfunction.
Research Areas: heart disease, immunology, cardiac function and dysfunction
The Adamo Lab aims to study applied immunology in the context of cardiac function and dysfunction, to both elucidate fundamental properties of the immune systems and to develop novel therapeutic options for the rapidly growing number of patients living with heart disease.
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Adult Cardiac Catheterization Laboratory
Our group is interested in the evaluation of basic pathophysiology in patients undergoing cardi...ac procedures, development and evaluation of new therapeutic strategies, and improving patient selection and outcomes following interventional procedures. view more
Research Areas: cardiac catheterization, Acute Myocardial Infarction -
Ayse Gurses Lab
Work in the Ayse Gurses Lab examines several topics related to human factors, including methods... for improving patient safety in the cardiac operating room, care coordination, transitions of care and compliance of providers with evidence-based guidelines. Our team also has an interest in research that explores the working conditions of nurses. We collaborate on studies related to the development of geriatrics health service delivery at all levels of the health system. view more
Research Areas: patient safety, human factors, informatics, care coordination, evidence-based medicine, gerontology -
Cammarato Lab
Lab WebsiteThe Cammarato Lab is located in the Division of Cardiology in the Department of Medicine at the... Johns Hopkins University School of Medicine. We are interested in basic mechanisms of striated muscle biology.
Research Areas: muscle development, genetics, myopathic processes, striated muscle biology, muscle function, myopathy, muscle physiology
We employ an array of imaging techniques to study “structural physiology” of cardiac and skeletal muscle. Drosophila melanogaster, the fruit fly, expresses both forms of striated muscle and benefits greatly from powerful genetic tools. We investigate conserved myopathic (muscle disease) processes and perform hierarchical and integrative analysis of muscle function from the level of single molecules and macromolecular complexes through the level of the tissue itself.
Anthony Ross Cammarato, MD, is an assistant professor of medicine in the Cardiology Department. He studies the identification and manipulation of age- and mutation-dependent modifiers of cardiac function, hierarchical modeling and imaging of contractile machinery, integrative analysis of striated muscle performance and myopathic processes. view more -
Cardiac Surgery Research Lab
Lab WebsiteFounded in 1942 by surgeon Alfred Blalock and surgical technician Vivien Thomas, the Cardiac Su...rgery Research Lab at The Johns Hopkins Hospital serves not only to spearhead discovery and innovation in cardiothoracic surgery, but also to train future leaders in the field. Active areas of investigation include the development of novel, nanoparticle-based therapeutics to mitigate acute lung injury, avoid neurological injury during cardiac surgery, and improve organ preservation during heart and lung transplantation. The lab is also active in a variety of clinical research projects aimed at improving outcomes for our patients.
Research Areas: cardiac surgery, nanotechnology, cardiothoracic surgery, surgical models, heart transplant, lung transplant
Equally important, the lab plays a critical role in training residents for impactful careers in academic cardiothoracic surgery. Medical students, residents, and fellows receive hands-on simulation experiences to hone surgical skills outside of the operating room. The lab also serves as a training ground to develop research and investigation skills as trainees learn methods of advanced statistical analysis and academic writing. Special programs for undergraduates and medical students help develop their passion for cardiac surgery and surgical research, giving unique opportunities to young talent. view more -
Cardiology Bioengineering Laboratory
Lab WebsiteThe Cardiology Bioengineering Laboratory, located in the Johns Hopkins Hospital, focuses on the... applications of advanced imaging techniques for arrhythmia management. The primary limitation of current fluoroscopy-guided techniques for ablation of cardiac arrhythmia is the inability to visualize soft tissues and 3-dimensional anatomic relationships.
Research Areas: magnetic resonance imaging, CPR models, cardiac mechanics, MRI-guided therapy, ischemic tachycardia, arrhythmia, cardiology, sudden cardiac death, cardiopulmonary resuscitation, computational modeling
Implementation of alternative advanced modalities has the potential to improve complex ablation procedures by guiding catheter placement, visualizing abnormal scar tissue, reducing procedural time devoted to mapping, and eliminating patient and operator exposure to radiation.
Active projects include
• Physiological differences between isolated hearts in ventricular fibrillation and pulseless electrical activity
• Successful ablation sites in ischemic ventricular tachycardia in a porcine model and the correlation to magnetic resonance imaging (MRI)
• MRI-guided radiofrequency ablation of canine atrial fibrillation, and diagnosis and intervention for arrhythmias
• Physiological and metabolic effects of interruptions in chest compressions during cardiopulmonary resuscitation
Henry Halperin, MD, is co-director of the Johns Hopkins Imaging Institute of Excellence and a
professor of medicine, radiology and biomedical engineering. Menekhem M. Zviman, PhD is the laboratory manager.
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Center for Research on Cardiac Intermediate Filaments
Lab WebsiteThe CRCIF was established to foster collaborative efforts aimed at elucidating the role of inte...rmediate filaments (IFs) in the heart. Intermediate filaments constitute a class of cytoskeletal proteins in metazoan cells, however, different from actin microfilaments and tubulin microtubules, their function in cardiac cells is poorly understood. Unique from the other two components of the cytoskeleton, IFs are formed by cell type-specific proteins. Desmin is the main component of the IFs in the cardiac myocytes. We measured the consistent induction of desmin post-translational modifications (PTMs, such as phosphorylation, etc.) in various clinical and experimental models of heart failure. Therefore, one of our main focuses is to determine the contribution of desmin PTMs to the development of heart failure in different animal and clinical models.
Research Areas: heart failure, intermediate filaments
Active Projects:
• Quantification of desmin PTM-forms in different forms of heart failure at the peptide level using mass spectrometry
• Functional assessment of the role of desmin PTMs in heart failure development using single site mutagenesis and biophysical methods
• Molecular characterization of desmin preamyloid oligomers using mass spectrometry, in vitro and in vivo imaging
• Assessment of the diagnostic and pharmacological value of desmin PTMs in heart failure development view more -
Chulan Kwon Laboratory
Lab WebsiteThe C. Kwon Lab studies the cellular and molecular mechanisms governing heart generation and re...generation.
Research Areas: stem cells, cell biology, heart regeneration, congenital heart disease, cardiovascular, molecular biology, cardiac cells
The limited regenerative capacity of the heart is a major factor in morbidity and mortality rates: Heart malformation is the most frequent form of human birth defects, and cardiovascular disease is the leading cause of death worldwide. Cardiovascular progenitor cells hold tremendous therapeutic potential due to their unique ability to expand and differentiate into various heart cell types.
Our laboratory seeks to understand the fundamental biology and regenerative potential of multi-potent cardiac progenitor cells – building blocks used to form the heart during fetal development — by deciphering the molecular and cellular mechanisms that control their induction, maintenance, and differentiation. We are also interested in elucidating the maturation event of heart muscle cells, an essential process to generate adult cardiomyocytes, which occurs after terminal differentiation of the progenitor cells. We believe this knowledge will contribute to our understanding of congenital and adult heart disease and be instrumental for stem cell-based heart regeneration.
We have developed several novel approaches to deconstruct the mechanisms, including the use of animal models and pluripotent stem cell systems. We expect this knowledge will help us better understand heart disease and will be instrumental for stem-cell-based disease modeling and interventions for of heart repair.
Dr. Chulan Kwon is an assistant professor of medicine at the Johns Hopkins University Heart and Vascular Institute. view more -
CORE-320 Multicenter Trial Lab
The central theme of the CORE-320 Multicenter Trial Lab’s research is to support the Coronary A...rtery Evaluation Using 320-Row Multidetector CT Angiography (CORE 320) study, a multi-center multinational diagnostic study with the primary objective to evaluate the diagnostic accuracy of 320-MDCT for detecting coronary artery luminal stenosis and corresponding myocardial perfusion deficits in patients with suspected CAD compared with the reference standard of conventional coronary angiography and SPECT myocardial perfusion imaging.
Research Areas: cardiac imaging, cardiac computing tomography, coronary risk prediction, heart attack prevention
Armin Arbab-Zadeh, MD, PhD, is an associate professor of medicine at the Johns Hopkins University School of Medicine and Director of Cardiac Computed Tomography in the Division of Cardiology at the Johns Hopkins Hospital in Baltimore.
Research Areas: coronary/cardiac imaging, coronary risk prediction, heart attack prevention, cardiac computed tomography, coronary circulation and disease
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Donald Shaffner Lab
Work in the Donald Shaffner Lab investigates several topics within critical care medicine. Our ...team conducts research on the mechanisms involved in neurologic injury from global ischemia as a result of cardiac arrest and resuscitation. We also study neurologic outcomes of pediatric patients who experience cardiac arrest. view more
Research Areas: hyperthermia, critical care medicine, cardiac arrest, resuscitation, ischemia, pediatrics, neurology -
Elizabeth Hunt Lab
Principal Investigator:
Elizabeth Hunt, M.D., Ph.D., M.P.H.
Anesthesiology and Critical Care MedicineResearchers in the Elizabeth Hunt Lab study innovative ways to improve the care quality and cli...nical outcomes of children who suffer cardiopulmonary arrest. Our work includes implementing rapid-response systems, capturing and analyzing cardiac-arrest data, and redesigning medical devices and simulators. We've introduced novel simulation approaches to education, including data-driven debriefing and the Rapid Cycle Deliberate Practice approach. view more
Research Areas: outcomes, pediatric cardiopulmonary arrest, rapid response systems, rapid cycle deliberate practice, pediatrics, quality of care -
Foster Lab
Lab WebsiteThe Foster Lab uses the tools of protein biochemistry and proteomics to tackle fundamental prob...lems in the fields of cardiac preconditioning and heart failure. Protein networks are perturbed in heart disease in a manner that correlates only weakly with changes in mRNA transcripts. Moreover, proteomic techniques afford the systematic assessment of post-translational modifications that regulate the activity of proteins responsible for every aspect of heart function from electrical excitation to contraction and metabolism. Understanding the status of protein networks in the diseased state is, therefore, key to discovering new therapies.
Research Areas: proteomics, protein biochemistry, heart failure, cardiology, cardiac preconditioning, cardiomyopathy
D. Brian Foster, Ph.D., is an assistant professor of medicine in the division of cardiology, and serves as Director of the Laboratory of Cardiovascular Biochemistry at the Johns Hopkins University School of Medicine.
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Interventional Cardiology Research Group
Our group is interested in a broad array of clinical and translational investigations spanning ...the evaluation of basic pathophysiology in patients undergoing cardiac procedures, development and evaluation of new therapeutic strategies, and improving patient selection and outcomes following interventional procedures. We are comprised of a core group of faculty and dedicated research nurses as well as fellows, residents, and students. Projects range from investigator-initiated single-center observational studies to industry-sponsored multicenter phase 3 randomized controlled trials. We have established a database of all patients who have undergone TAVR at Johns Hopkins, which is providing the basis for several retrospective analyses and will serve as the foundation for future studies of TAVR. We are also engaged in collaborative projects with other groups from the Department of Medicine and other Departments including Cardiac Surgery, Anesthesiology, Radiology, Psychiatry, and Biomedical Engineering. Members of our group are actively involved with the Johns Hopkins Center for Bioengineering Innovation and Design (CBID) in the development of novel minimally-invasive cardiovascular devices. view more
Research Areas: coronary CT angiography, PCI, bioprosthetic leaflet thrombosis, myocardial regeneration, TAVR -
Joseph Mankowski Lab
The Joseph Mankowski Lab studies the immunopathogenesis of HIV infection using the SIV/macaque ...model. Our researchers use a multidisciplinary approach to dissect the mechanism underlying HIV-induced nervous system and cardiac diseases. Additionally, we study the role that host genetics play in HIV-associated cognitive disorders. view more
Research Areas: macaques, HIV, genomics, SIV, pathogenesis, cardiology, nervous system -
Kass Lab
Lab WebsiteBasic science investigations span an array of inquiries, such as understanding the basic mechan...isms underlying cardiac dyssynchrony and resynchronization in the failing heart, and beneficial influences of nitric oxide/cGMP/protein kinase G and cGMP-targeted phosphdiesterase signaling cascades on cardiac maladaptive stress remodeling. Recently, the latter has particularly focused on the role of phosphodiesterase type 5 and its pharmacologic inhibitors (e.g. sildenafi, Viagra®), on myocyte signaling cascades modulated by protein kinase G, and on the nitric oxide synthase dysregulation coupled with oxidant stress.
Research Areas: pulmonary hypertension, heart disease, cardiac hypertrophy, heart failure, cardiology
The lab also conducts clinical research and is presently exploring new treatments for heart failure with a preserved ejection fraction, studying ventricular-arterial interaction and its role in adverse heart-vessel coupling in left heart failure and pulmonary hypertension, and testing new drug, device, and cell therapies for heart disease. A major theme has been with the use of advanced non-invasive and invasive catheterization-based methods to assess cardiac mechanics in patients.asive and invasive catheterization-based methods to assess cardiac mechanics in patients.
David Kass, MD, is currently the Director at the Johns Hopkins Center for Molecular Cardiobiology and a professor in cellular and molecular medicine. view more -
Kathleen Gabrielson Laboratory
Research in the Kathleen Gabrielson Laboratory focuses on the signal transduction of cardiovasc...ular toxicities in vitro, in cardiomyocyte culture and in vivo using rodent models. Specifically, the research focuses on understanding the mechanisms of various cancer therapies that induce cardiac toxicities.
Research Areas: cardiovascular toxicity, cancer, pathology, signal transduction
Currently, we are testing prevention strategies for these toxicities by studying the cardiac effects of the anthracycline doxorubicin (adriamycin) and the immunotherapeutic agent, Herceptin, anti-erbB2. We are focusing on the signal transduction pathways in the heart that are modulated by anti-erbB2 treatment, which in turn, worsens doxorubicin toxicity. Thus, understanding the mechanisms behind the combined toxicity of doxorubicin and anti-erbB2 will pave the way for the design of strategies to reduce toxicity, identify patients at risk and potentially allow higher levels of this effective combination therapy to be used with an improved long-term survival in patients. view more -
Lima Lab
Lab WebsiteThe Lima Lab’s research is concentrated on the development and application of imaging and techn...ology to address scientific and clinical problems involving the heart and vascular system.
Research Areas: magnetic resonance, cerebrovascular, imaging, cardiovascular, cardiology, atherosclerosis, computed tomography, vascular, myocardial infarction
Specifically, our research is focused on developing magnetic resonance imaging (MRI) contrast techniques to investigate microvascular function in patients and experimental animals with myocardial infarction; functional reserve secondary to dobutamine stimulation and myocardial viability assessed by sodium imaging; and cardiac MRI and computed tomography (CT) program development of techniques to characterize atherosclerosis in humans with cardiovascular or cerebrovascular disease.
Current projects include:
• The Coronary Artery Risk Development in Young Adults (CARDIA) Study
• The MESA (Multi-Ethnic Study of Atherosclerosis) Study
• The Coronary Artery Evaluation using 64-row Multidetector Computed Tomography Angiography (CORE64) Study
Joao Lima, MD, is a professor of medicine, radiology and epidemiology at the Johns Hopkins School of Medicine. view more -
Mary Beth Brady Lab
Lab WebsiteResearch in the Mary Beth Brady Lab focuses primarily on topics within the fields of anesthesio...logy, imaging and cardiology. Our work has explored transesophageal echocardiography simulation, echocardiography, cardiac and vascular-thoracic anesthesiology, and other areas within critical care medicine. A recent study involved obtaining 3-D images of the heart, which were then used to build computer programs to help cardiac surgeons improve their treatment of heart defects. view more
Research Areas: critical care medicine, cardiac anesthesiology, imaging, transesophageal echocardiogram, anesthesiology, cardiology, echocardiography, vascular-thoracic anesthesiology -
O'Rourke Lab
Lab WebsiteThe O’Rourke Lab uses an integrated approach to study the biophysics and physiology of cardiac ...cells in normal and diseased states.
Research Areas: biophysics, ischemia-reperfusion injury, imaging, electrophysiology, cardiovascular, arrhythmia, physiology, sudden cardiac death, molecular biology, cardiac cells
Research in our lab has incorporated mitochondrial energetics, Ca2+ dynamics, and electrophysiology to provide tools for studying how defective function of one component of the cell can lead to catastrophic effects on whole cell and whole organ function. By understanding the links between Ca2+, electrical excitability and energy production, we hope to understand the cellular basis of cardiac arrhythmias, ischemia-reperfusion injury, and sudden death.
We use state-of-the-art techniques, including single-channel and whole-cell patch clamp, microfluorimetry, conventional and two-photon fluorescence imaging, and molecular biology to study the structure and function of single proteins to the intact muscle. Experimental results are compared with simulations of computational models in order to understand the findings in the context of the system as a whole.
Ongoing studies in our lab are focused on identifying the specific molecular targets modified by oxidative or ischemic stress and how they affect mitochondrial and whole heart function.
The motivation for all of the work is to understand
• how the molecular details of the heart cell work together to maintain function and
• how the synchronization of the parts can go wrong
Rational strategies can then be devised to correct dysfunction during the progression of disease through a comprehensive understanding of basic mechanisms.
Brian O’Rourke, PhD, is a professor in the Division of Cardiology and Vice Chair of Basic and Translational Research, Department of Medicine, at the Johns Hopkins University. view more -
Pediatric Cardiology Core Imaging Laboratory
The lab’s assets include three MRI systems available for pediatric studies, cardiac imaging pro...cessing, cardiovascular imaging and therapeutic ultrasound. A robust echocardiogram program conducts 10,000 transthoracic echocardiograms and 1,300 fetal echocardiograms per year, and maintains a database with 10 years of data. view more
Research Areas: cardiac imaging, pediatric cardiology -
Post Lab
Lab WebsiteThe Post Lab is involved in the Multi-Ethnic Study of Atherosclerosis (MESA), a collaborative s...tudy of the characteristics of subclinical cardiovascular disease (that is, disease detected non-invasively before it has produced clinical signs and symptoms) and the risk factors that predict progression to clinically overt cardiovascular disease or progression of the subclinical disease.
Research Areas: coronary artery disease, cardiovascular, ethnicity, pathogenesis, atherosclerosis, sudden cardiac death
As MESA researchers, we study a diverse, population-based sample of 6,814 asymptomatic men and women aged 45-84. Approximately 38 percent of the recruited participants are white, 28 percent African-American, 22 percent Hispanic, and 12 percent Asian, predominantly of Chinese descent.
Participants were recruited from six field centers across the United States, including Johns Hopkins University. Each participant received an extensive physical exam to determine a number of conditions, including coronary calcification, ventricular mass and function, flow-mediated endothelial vasodilation, standard coronary risk factors, sociodemographic factors, lifestyle factors, and psychosocial factors.
Selected repetition of subclinical disease measures and risk factors at follow-up visits have allowed study of the progression of disease. Participants are being followed for identification and characterization of cardiovascular disease events, including acute myocardial infarction and other forms of coronary heart disease (CHD), stroke, and congestive heart failure; for cardiovascular disease interventions; and for mortality.
Wendy S. Post, MD, MS, is an associate faculty, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, and a professor of medicine. view more -
Reid Thompson Laboratory
Reid Thompson’s research interests include evaluation of ventricular function in patients with ...muscular dystrophy and Barth syndrome, and in patients who have completed chemotherapy. He also studies novel methods of teaching and diagnosing heart disease through cardiac auscultation. view more
Research Areas: Barth syndrome, pediatric cardiology, muscular dystrophy -
Retrovirus Laboratory
Research in the Retrovirus Laboratory focuses on the molecular virology and pathogenesis of len...tivirus infections. In particular, we study the simian immunodeficiency virus (SIV) to determine the molecular basis for the development of HIV CNS, pulmonary and cardiac disease.
Research Areas: HIV, genomics, pulmonology, SIV, cardiology, lentivirus
Research projects include studies of viral molecular genetics and host cell genes and proteins involved in the pathogenesis of disease. We are also interested in studies of lentivirus replication in macrophages and astrocytes and their role in the development of disease. These studies have led us to identify the viral genes that are important in neurovirulence of SIV and the development of CNS disease including NEF and the TM portion of ENV. The mechanisms of the action of these proteins in the CNS are complex and are under investigation. We have also developed a rapid, consistent SIV/macaque model in which we can test the ability of various antiviral and neuroprotective agents to reduce the severity of CNS and pulmonary disease. view more -
The Arking Lab
The Arking Lab studies the genomics of complex human disease, with the primary goal of identify...ing and characterizing genetics variants that modify risk for human disease. The group has pioneered the use of genome-wide association studies (GWAS), which allow for an unbiased screen of virtually all common genetic variants in the genome. The lab is currently developing improved GWAS methodology, as well as exploring the integration of additional genome level data (RNA expression, DNA methylation, protein expression) to improve the power to identify specific genetic influences of disease.
Research Areas: autism, genetics, aging, cardiovascular diseases, sudden cardiac death
The Arking Lab is actively involved in researching:
• autism, a childhood neuropsychiatric disorder
• cardiovascular genomics, with a focus on electrophysiology and sudden cardiac death (SCD)
• electrophysiology is the study of the flow of ions in biological tissues
Dan E. Arking, PhD, is an associate professor at the McKusick-Nathans Institute of Genetic Medicine and Department of Medicine, Division of Cardiology, Johns Hopkins University. view more -
The Atlantic Cardiovascular Patient Outcomes Research Team - Atlantic C-PORT
Our research is centered on the safety, efficacy and outcomes of PCI performed at hospitals wit...hout on-site cardiac surgery.
Research Areas: cardiac surgery, cardiology
Active projects:
C-PORT Randomized Studies and Registries; New Jersey Angioplasty Demonstration Project; InCar-decision support tools for performance of PCI at hospitals without on-site cardiac surgery.
For more information please visit Cport.org. view more -
The Barouch Lab
The Barouch Lab is focused on defining the peripheral cardiovascular effects of the adipocytoki...ne leptin, which is a key to the understanding of obesity-related cardiovascular disease. Interestingly, many of the hormonal abnormalities seen in obesity are mimicked in heart failure. The research program will enhance the understanding of metabolic signaling in the heart, including the effects of leptin, exercise, sex hormones, and downstream signaling pathways on metabolism and cardiovascular function.
Research Areas: cardiac remodeling, cardiac hypertrophy, obesity, cognitive heart failure
The lab also is working to determine the precise role of the “metabolic” beta-3 adrenergic receptor (ß3AR) in the heart and define the extent of its protective effect in obesity and in heart failure, including its role in maintaining nitric oxide synthase (NOS) coupling. Ultimately, this work will enable the exploration of a possible therapeutic role of ß3AR agonists and re-coupling of NOS in preventing adverse ventricular remodeling in obesity and in heart failure.
Lili Barouch, MD, is an associate professor of medicine in the Division of Cardiology and a member of the Advanced Heart Failure and Cardiac Transplantation group at the Johns Hopkins University School of Medicine. view more -
Weiss Lab
Lab WebsiteThe Weiss Lab, which features a multi-disciplinary team at Johns Hopkins as well as at Cedars S...inai Medical Center in Los Angeles, is dedicated to identifying the most important clinical, genetic, structural, contractile and metabolic causes of sudden cardiac death as well as the means to reverse the underlying pathology and lower risk.
Research Areas: energy metabolism, creatine kinase metabolism, imaging, heart failure, aging, cardiology, sudden cardiac death
Current projects include research into energy metabolism in human heart failure and creatine kinase metabolism in animal models of heart failure.
Robert G. Weiss, MD, is professor of medicine, Radiology and Radiological Science, at the Johns Hopkins University. view more -
Wu Lab
Dr. Wu leads a multi-disciplinary team with collaborators from the Bloomberg School of Public H...ealth, JHU Whiting School of Engineering, and JHU Krieger School of Arts and Sciences. She conducts ongoing investigations with the Multicenter AIDS Cohort Study and Women’s Inter-agency Health Study. Her lab’s goals are to develop, implement, and validate novel imaging-based metrics of cardiac structure and function to improve risk prediction and stratification at the individual patient-level.
Research Areas: AIDS, HIV, risk prediction, myocardial disease
Research Focuses:
Predictors of Sudden Cardiac Death by Magnetic Resonance Imaging
Subclinical myocardial disease in people living with HIV
Individualized risk prediction
Cardiac structural and mechanical modeling view more -
Zambidis Laboratory
The Zambidis Labratory studies the formation of pluripotent stem cells and the subsequent hemat...opoietic, endothelial and cardiac differentiation, as well as the potential therapeutic uses of pluripotent stem cell-derived cells. view more
Research Areas: stem cells, vasculogenesis, cardiogenesis, hematopoiesis, cancer stem cells, pluripotency
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